Association of Structured Preclinical Phantom Training and OSCE/OSPE-Based Assessment with Endodontic Procedural Complications Among Dental Students: A Retrospective Cohort Study

Background/Objectives: The aim of this retrospective cohort study was to evaluate the association between structured phantom laboratory training and Objective Structured Clinical Examination (OSCE)/Objective Structured Practical Examination (OSPE)-based assessment and procedural complications observed during root canal treatments performed by undergraduate dental students in the clinical setting. Methods: Periapical radiographs obtained from 1204 completed root canal treatments performed at the Department of Endodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, were evaluated. The teeth that underwent root canal treatment in the clinic by students who had not received structured phantom laboratory training and OSCE/OSPE-based assessment and by those who had received this training were divided into two groups, comprising 722 teeth and 482 teeth, respectively. The association between training status and overall procedural complications was analyzed using generalized linear mixed models (GLMMs), taking into account the clustering of treatments within students. Results: The prevalence of at least one procedural complication was 42.9% in the non-training group and 37.8% in the training group. In the primary GLMM analysis adjusted for the number of treated teeth per student, training status was not significantly associated with the overall occurrence of procedural complications (odds ratio (OR) = 0.58, 95% confidence interval (CI): 0.29–1.16, p = 0.069). In the secondary/exploratory analyses, lower odds of canal transportation (OR = 0.12, 95% CI: 0.02–0.94, p = 0.044) and overfilling (OR = 0.56, 95% CI: 0.38–0.82, p = 0.003) were observed in the training group, whereas the odds of missed canals were higher (OR = 6.23, 95% CI: 2.08–18.65, p = 0.001). The likelihood of procedural complications was higher in molar teeth than in anterior teeth (OR = 5.84, 95% CI: 3.66–9.46, p < 0.001). Conclusions: Although structured phantom laboratory training and OSCE/OSPE-based assessment were not significantly associated with the overall occurrence of procedural complications, exposure to the revised educational program was associated with lower odds of certain technical errors.